Medico-Legal Journal

Covid-19 requires practitioners to reflect on how they deliver health services. Using technology, in particular video technology, has increased, especially in primary care. This article considers the implications of technology for assessments under the Mental Health Act 1983. NHS Covid-19 guidance anticipated its use in assessments, but this was held to be unlawful. Is this the right decision or is it too restrictive an interpretation of the 1983 Act? The article argues that consideration should be given to the potential role, if any, of video technology in assessments and identifies some issues that need to be addressed. Use of these technologies should be part of the current review of the 1983 legislation.

In 1877 Harriet Staunton died in Penge, Kent, and four members of her family were convicted of her murder by malicious starvation. The defence attempted to show that she had died from tuberculous meningitis, but reappraisal of the evidence leads to the conclusion that she died from tuberculous Addison’s disease and that the defendants were wrongly convicted.

Litigation over medical mishaps – NHS Resolution – extent of damages and costs – the relationship between doctor and midwife – celebrated or notorious cases, Mid Staffs, Morecambe Bay, Northwick Park – informing patient of risks – meaning of wrongful birth – contemporary tests for negligence.

An Air India Express Flight AI1344 travelling from Dubai to Calicut (Kozhikode), when attempting to land, unfortunately, overshot the runway and crashed causing many casualties as the impact caused the aircraft to break up into multiple pieces. The response to a disaster, specifically an aviation disaster, is highly complex. It involves multiple government agencies and calls for a truly inter/multidisciplinary response from diverse domains including forensic experts, fire experts, aeronautical engineers, humanitarian experts who must together form an ideal post-rescue recovery team. The author was intricately involved in the recovery mission launched after the above air disaster. This case study considers the process of collecting and managing the personal effects of those affected along with the various challenges involved.

Binge eating is characterised by the ingestion of large quantities of food in a short time. Cases in the literature deal exclusively with gastric perforation in people with a history of anorexia nervosa, binge eating disorder or bulimia nervosa.

We report the case of a young woman with no previous diagnosis of mental illness and a history of only two binge-eating episodes that occurred a few years earlier. She died suddenly during a binge-eating episode from stomach rupture resulting from a single perforation of the stomach with leakage of food material within the abdominal cavity. There was no sign of gastric necrosis or peritonitis. The deceased died quickly.

Our case, which appears unique in the literature, shows that there is a risk of death even in people with no diagnosis of eating disorders and a history of only few and isolated binge-eating episodes. Physicians should carefully investigate a patient's history to assess any risks.

Few studies consider the effects of impaction, resulting in inaccurate estimation of age using third molar. We aimed to assess the significance of impaction in estimating age using Modified Demirjian’s method. 200 orthopantomograms of patients between 16–25 years were collected comprising 171 tests and 212 controls. Chronologic age (CA) and estimated age (EA) were calculated. Independent sample t-test, chi-square test, paired t-test and Kolmogrov-Smirnov test of normality were used. The mean difference between the CA and EA in both the tests and control samples were significant (mean difference test group = 2.6 ± 2.07, control group = 2.0 ± 1.8; p = 0.01). It provided a difference of 0.6 which is equal to 7.2 months. The results of our study indicate that impacted mandibular third molars are susceptible to undergo slower mineralization, leading to erroneous lower age estimation. These results in an Indian population are noteworthy. However further studies are needed.

Female homicide or femicide is an increasingly worrying and complex problem for many western European countries and continues to be a major issue globally. The Republic of Ireland has seen a substantial increase in cases of female homicide in recent years prompting an outcry from both women’s groups and the wider public, which has led to discussions within government as to the best way forward in dealing with the ever-increasing situation of unlawful killing of women in the country. Despite the outrage little research exists on the subject beyond the newspaper headlines and media reporting. In a review of 240 cases of female homicide over a 30-year period from 1991–2021 using newspapers and court reports, many patterns emerge regarding the causes of death and motives behind the killings.

Complicated suicides can be defined as incidents where death is caused by a subsequent trauma rather than the primary injury. Deaths which occur as a complication of the suicidal act are very rare with few reports in the literature. We present the case of a 60-year-old man who was found at his home while still alive. His body was burning and he was lying on his back impaled by shards of glass that had come from a broken glass door. An ambulance was called but the man died before arrival at hospital. The autopsy showed stab heart and lung injuries in thorax and an abdominal stab trauma which resulted in the protrusion of the small intestine. Homicide was excluded and the sequence of events was reconstructed to reveal a complicated suicide intended to result from self-immolation but which resulted in a fall against a glass door which in turn resulted in shards of glass piercing his body and a fatal stab wound to the heart.

Forensic anthropology utilises the knowledge gained from the examination of human remains. It is a requirement for forensic medicine residents to have knowledge of forensic anthropology and exhumation. Most of the forensic medicine residents in the Indian sub-continent graduate only with a theoretical knowledge and without a proper practical training of the process involved. We demonstrate how hands-on training would be beneficial.